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01.
arXiv (CS.AI) 2026-06-18

From Values to Tokens: An LLM-Driven Framework for Context-aware Time Series Forecasting via Symbolic Discretization

arXiv:2508.09191v2 Announce Type: replace-cross Abstract: Time series forecasting plays a vital role in supporting decision-making across a wide range of critical applications, including energy, healthcare, and finance. Despite recent advances, forecasting accuracy remains limited due to the challenge of integrating historical numerical sequences with contextual features, which often comprise unstructured textual data. To address this challenge, we propose TokenCast, a large language model (LLM) driven framework that leverages language-based symbolic representations as a unified intermediary for context-aware time series forecasting. Specifically, TokenCast employs a discrete tokenizer to transform continuous numerical sequences into temporal tokens, enabling structural alignment with language-based inputs. To effectively bridge the semantic gap between modalities, both temporal and contextual tokens are embedded into a shared representation space via a pre-trained LLM, further optimized with generative objectives. Building upon this unified semantic space, the aligned LLM is subsequently fine-tuned in a supervised manner to predict future temporal tokens, which are then decoded back into the original numerical space. Extensive experiments on real-world datasets demonstrate the effectiveness of our framework and highlight its potential as a generative framework for context-aware time series forecasting. The code is available at https://github.com/Xiaoyu-Tao/TokenCast.

02.
arXiv (CS.CL) 2026-06-17

The Benchmark Illusion: Pruned LLMs Can Pass Multiple Choice but Fail to Answer

Compressing large language models reduces memory use and inference cost, but it can also create failures that standard benchmarks miss. A pruned model may still perform well on multiple-choice evaluations, yet fail to answer the same question in open generation. We ask what pruning changes: does it erase the correct answer, or does it make the answer harder to produce as the top output? We study this question with multilingual question answering, tracking the same questions before and after pruning. We find a benchmark illusion. Under high-sparsity pruning, especially Wanda, models often fail in greedy open generation while still selecting the correct answer under multiple-choice scoring. In these recognition-only errors, the answer is usually not gone, but demoted: it often reappears with beam search, sampling, or one in-context example. Overall, multiple-choice benchmarks can overstate the usability of compressed LLMs, creating an evaluation blind spot. Compressed models should be tested on what they can produce, not only on what they can recognize.

03.
arXiv (CS.LG) 2026-06-17

A Diffusion Approximation for Temporal-Difference Learning with Linear Features under Markovian Noise

arXiv:2606.18183v1 Announce Type: cross Abstract: Temporal difference (TD) learning with linear function approximation is a core method for policy evaluation. Its classical continuous-time description is an ordinary differential equation (ODE), which captures the asymptotic mean dynamics but neglects stochastic fluctuations determining the error floor. We introduce a stochastic differential equation (SDE) approximation for linear TD(0) under Markovian noise. The resulting model distinguishes the contraction dynamics governed by the projected Bellman operator from the influence of Markovian sampling. As a consequence, the model explains the constant-stepsize error floor through the interaction between Markovian long-run covariance and the contraction geometry of the projected Bellman operator.

04.
arXiv (CS.CL) 2026-06-12

PolyAlign: Conditional Human-Distribution Alignment

Post-training methods such as supervised fine-tuning (SFT) and preference optimization typically align language models toward a single global assistant behavior. While effective for improving average helpfulness, this can suppress the natural variation of human responses across languages, tasks, and dialogue settings. We study this problem as conditional human-distribution alignment: models should match the human response distribution appropriate to the current interaction context, rather than a universal response style. We introduce PolyAlign, a distribution-aware alignment framework that organizes bilingual interaction data into bucket-specific human reference distributions defined by language, interaction track, response family, and length. PolyAlign combines Bucket-Aware SFT, which balances optimization across heterogeneous buckets, with Human-Distribution Preference Optimization (HDPO), which regularizes preference learning using critic-estimated distance to bucket-specific human support. Across a bilingual evaluation suite covering English and Chinese single- and multi-turn settings, PolyAlign improves conditional naturalness and distributional faithfulness while preserving competitive task utility. The results suggest that post-training should move beyond global alignment objectives toward interaction-aware alignment with human response distributions.

06.
arXiv (CS.CV) 2026-06-12

Bounding Boxes as Goals: Language-Conditioned Grasping via Neuro-Symbolic Planning

For robotics to be effectively integrated into household or industrial environments, machines must adapt to natural-language prompts in real time. Although Vision-Language Models (VLMs) have enabled zero-shot generalization in robot task and motion planning (TAMP), current state-of-the-art approaches often remain computationally "heavyweight" or require extensive training on thousands of demonstrations. We present GRASP (Grounded Reasoning and Symbolic Planning), a framework designed as a step toward open-vocabulary tabletop manipulation. Our approach leverages a pretrained VLM to translate natural-language queries into neuro-symbolic goal states, grounded in the physical world via a bounding-box detection pipeline. Unlike methods that rely on fixed color lists or hard-coded coordinates, GRASP enables robots to interpret abstract spatial concepts such as "top shelf" and execute tasks without additional fine-tuning. We achieve 73.3% overall success across 90 real-robot trials at three difficulty levels, requiring no task-specific training.

07.
arXiv (CS.CL) 2026-06-17

Self-Generated Error Training for Token Editing in Diffusion Language Models

Authors:

Token-to-token (T2T) editing lets LLaDA2.1 revise committed tokens during block-diffusion decoding. The released recipe trains this editor on random vocabulary corruptions, but at inference the editor sees the model's own fluent, high-confidence draft errors instead. We study this training-inference mismatch and propose self-generated T2T, which performs a no-gradient draft pass, fills masked positions with predicted tokens, and supervises recovery in a second pass under these self-generated corruptions. We implement the update as a short LoRA continued-pretraining pass on LLaDA2.1-mini and evaluate on several benchmarks under the official Q-Mode T2T procedure with unchanged inference parameters. The method generally improves accuracy while reducing T2T edit intensity, mitigating failure modes such as final-digit transcription errors after otherwise correct reasoning and excessive self-correction before short factual answers.

08.
arXiv (CS.AI) 2026-06-16

NVMOS: Non-Verbal Vocalization Quality Assessment in Speech

arXiv:2606.15888v1 Announce Type: cross Abstract: Non-verbal vocalizations (NVs), such as laughter, sighs, and coughs, are important acoustic cues for emotion and intent. Existing speech quality assessment methods typically focus on overall naturalness, while non-verbal TTS evaluations mainly examine whether a target NV appears with the correct type and position. However, the perceptual quality of NV events themselves remains underexplored. To address this gap, we construct an NV-MOS dataset containing outputs from multiple NV-TTS systems and naturally occurring NV samples, with ratings collected from three acoustic experts on a perceptual quality scale. We further analyze audio-capable multimodal large language models such as Gemini and find clear inconsistencies between their scores and expert ratings. These results suggest that general-purpose multimodal models cannot reliably replace human judgments for NV quality assessment. We then propose NVMOS, to our knowledge the first model that can reliably predict the perceptual quality of NV events in speech. Experimental results show that, with a local NV-event focusing module, NVMOS reaches expert-level or stronger agreement with human MOS.

09.
arXiv (CS.CL) 2026-06-16

XAI-Grounded Explanation Generation for Speech Deepfake Detection with Training-Free Multimodal Large Language Models

Speech deepfake detection (SDD) systems require trustworthy explanations for reliable decision-making. Existing explanation ways mainly fall into two categories. Traditional explainable AI (XAI), such as gradient-based attribution, produces low-level attribution signals tightly coupled with model decisions, and harder to be understood by human than natural language explanations. Meanwhile, large language model (LLM)-based explanation generation often produces generic and ungrounded descriptions due to the lack of heuristic evidence and task-specific supervision, stemming from limited grounded explanation datasets for SDD. We therefore propose a training-free explanation framework that integrates XAI evidence with multimodal LLMs to generate grounded and specific explanations. Using the PartialSpoof dataset, we construct a grounded explanation dataset and show that methods with XAI increase inside accuracy by over 45\%, verified through human evaluation and faithfulness checks.

10.
medRxiv (Medicine) 2026-06-15

Routine use of oral iron for people with heart failure and iron deficiency in primary care; retrospective cohort study

Aims: Iron deficiency is common among people with heart failure and associated with morbidity and mortality. While intravenous iron improves clinical outcomes, oral iron continues to be prescribed in routine practice despite limited evidence of benefit. Methods: We completed a retrospective primary care cohort study (2016 to 2021) to investigate the proportion of people with an incident diagnosis of heart failure who had iron deficiency identified (defined as ferritin

11.
arXiv (CS.AI) 2026-06-19

The Tao of Agency: Autotelic AI, Embedded Agency and Dissolution of the Self

Authors:

arXiv:2606.19924v1 Announce Type: new Abstract: Most artificial intelligence systems are built on the assumption that goals are exogenous and specified by the designer. Exploring what happens when an agent begins generating its own goals opens the field of autotelic AI. Agents are expected not merely to pursue objectives but to discover them. In this article, we trace its consequences through intrinsic motivation, resource-driven priors, causal-interventional learning, homeostasis, and embeddedness; the last of which is found to be a necessary but not sufficient condition for autotelic agency. Embeddedness individuates the agent at the cost of revealing that the individuation is non-unique, such that the same dynamics admit many valid partitions, each defining a different candidate self. The deepest problem with autotelic AI is therefore not how the agent generates goals, but how it generates and relativizes the self to which the goals are assigned. The agent must believe in its own boundary in order to act, and see through that boundary in order to understand. We consolidate these developments into a single framework and extend it along three directions: a quantum formulation in which the agent-environment cut becomes physical, a philosophical reading against non-dual contemplative traditions, and a concrete LLM-based agentic instantiation.

12.
arXiv (CS.AI) 2026-06-17

A homotopy-type-theoretic generalization of neurosymbolic inference

arXiv:2606.17851v1 Announce Type: new Abstract: A wide range of neurosymbolic (NeSy) systems compute one functional: a belief-weighted sum of a logical quantity over a space of $\sigma$-structures, of which weighted model counting, fuzzy logic, and probabilistic logic are special cases. This account is built on sets, and a set deliberately forgets two things that are important for NeSy: when two $\sigma$-structures are the same up to a symmetry of the theory, and how many distinct proofs witness a query. Replacing the underlying sets by types, in the sense of homotopy type theory, preserves this information, and turns this functional into a belief-weighted homotopy cardinality, a notion of size that counts each object in inverse proportion to its symmetries. We develop the framework from scratch for NeSy systems, prove a conservativity theorem that recovers the classical functional when symmetries are trivial, and show that the symmetry our framework exposes is exactly the one behind reasoning shortcuts. The payoff is concrete: the shortcut-aware concept posterior that recent methods reach by ensembling or expressive density estimation is the only symmetry-invariant point of the confusion-set simplex, computable in closed form by averaging a single model over the symmetry group. On MNIST reasoning-shortcut benchmarks this single-model wrapper is better calibrated than a diversity-trained ensemble, while leaving label accuracy and identifiable concepts untouched. Code is freely available at https://github.com/bio-ontology-research-group/hott-nesy.

13.
arXiv (CS.LG) 2026-06-11

Prediction-Powered Risk Monitoring of Deployed Models for Detecting Harmful Distribution Shifts

arXiv:2602.02229v2 Announce Type: replace Abstract: We study the problem of monitoring model performance in dynamic environments where labeled data are limited. To this end, we propose prediction-powered risk monitoring (PPRM), a semi-supervised risk-monitoring approach based on prediction-powered inference (PPI). PPRM constructs anytime-valid lower bounds on the running risk by combining synthetic labels with a small set of true labels. Harmful shifts are detected via a threshold-based comparison with an upper bound on the nominal risk, satisfying assumption-free finite-sample guarantees on the type-I error. We demonstrate the effectiveness of PPRM through extensive experiments on image classification, large language model (LLM), and telecommunications monitoring tasks.

14.
arXiv (CS.AI) 2026-06-16

STRIDE: Strategic Trajectory Reasoning via Discriminative Estimation for Verifiable Reinforcement Learning

arXiv:2606.15866v1 Announce Type: new Abstract: Reinforcement Learning with Verifiable Rewards (RLVR) has become an effective post-training paradigm for improving the reasoning abilities of large language models. However, existing RLVR methods typically rely on final-answer correctness to assign trajectory-level rewards, providing sparse supervision and treating all tokens uniformly regardless of their actual contribution to reasoning. Although recent studies introduce intermediate signals such as process rewards, high-entropy tokens, and semantic uncertainty, these signals are often not inherently verifiable and may fail to distinguish beneficial strategic patterns from harmful ones. To address this limitation, we propose STRIDE (Strategic Trajectory Reasoning with Discriminative Estimation), a fine-grained RLVR framework that derives strategic reasoning supervision from verifiable outcomes. STRIDE contrasts successful and failed trajectories within each response group to estimate the outcome-discriminative preference of each $n$-gram strategic pattern, and further combines this signal with reasoning saliency entropy to identify decision-relevant strategic patterns. These patterns are assigned differentiated advantage values during RL optimization, enabling more precise credit assignment while preserving the verifiability of RLVR. Extensive experiments demonstrate that STRIDE consistently improves reasoning performance across diverse models, tasks, and extended settings, including VLMs and agent-based systems.

15.
arXiv (math.PR) 2026-06-18

On the Singular Control of a Diffusion and its Running Infimum or Supremum

arXiv:2501.17577v2 Announce Type: replace-cross Abstract: We study a class of singular stochastic control problems for a one-dimensional diffusion $X$ in which the performance criterion to be optimised depends explicitly on the running infimum $I$ (or supremum $S$) of the controlled process. We introduce two novel integral operators that are consistent with the Hamilton-Jacobi-Bellman equation for the resulting two-dimensional singular control problems. The first operator involves integrals where the integrator is the control process of the two-dimensional process $(X,I)$ or $(X,S)$; the second operator concerns integrals where the integrator is the running infimum or supremum process itself. Using these definitions, we prove a general verification theorem for problems involving two-dimensional state-dependent running costs, costs of controlling the process, costs of increasing the running infimum (or supremum) and exit times. Finally, we apply our results to explicitly solve an optimal dividend problem in which the manager's time-preferences depend on the company's historical worst performance.

16.
arXiv (CS.LG) 2026-06-18

KEPLA: A Knowledge-Enhanced Deep Learning Framework for Accurate Protein-Ligand Binding Affinity Prediction

arXiv:2506.13196v5 Announce Type: replace Abstract: Accurate prediction of protein-ligand binding affinity is critical for drug discovery. While recent deep learning approaches have demonstrated promising results, they often rely solely on structural features of proteins and ligands, overlooking their valuable biochemical knowledge associated with binding affinity. To address this limitation, we propose KEPLA, a novel deep learning framework that explicitly integrates prior knowledge from Gene Ontology and ligand properties to enhance prediction performance. KEPLA takes protein sequences and ligand molecular graphs as input and optimizes two complementary objectives: (1) aligning global representations with knowledge graph relations to capture domain-specific biochemical insights, and (2) leveraging cross attention between local representations to construct fine-grained joint embeddings for prediction. Experiments on two benchmark datasets across both in-domain and cross-domain scenarios demonstrate that KEPLA consistently outperforms state-of-the-art baselines. Furthermore, interpretability analyses based on knowledge graph relations and cross attention maps provide valuable insights into the underlying predictive mechanisms.

17.
arXiv (CS.AI) 2026-06-18

Caring Without Feeling: Affective Dynamics as the Control Layer of Human-AI Agent Collaboration

arXiv:2606.18259v1 Announce Type: cross Abstract: AI agents that plan, retain memory across sessions, invoke external tools and act with partial autonomy are transforming human–AI collaboration. Research on affective computing, simulated empathy in large language models, trust in automation and AI safety has illuminated important design principles, yet these literatures remain fragmented. No integrated account explains how affective cues operate within agentic collaboration – settings in which humans delegate, monitor and correct consequential tasks. This Review synthesises computational and interactional mechanisms of affective dynamics: the processes through which affective cues, emotion-like behaviour and perceived agent affect shape trust calibration, delegation decisions, error correction, dependence and governance. We trace how model-generated affective signals enter interaction loops that govern reliance, repair and oversight, and propose a framework that treats affect not as an internal property of AI but as a coordination layer through which humans and agents negotiate capability, uncertainty and responsibility. The framework provides a foundation for calibrated measurement, purposeful design and informed governance.

18.
medRxiv (Medicine) 2026-06-11

Wealth-Related Inequalities in Cesarean Section Utilization Among Facility-Based Births in Bangladesh: Evidence from Public and Private Healthcare Facilities

Authors:

Background Bangladesh has experienced a rapid increase in cesarean section (CS) utilization over the past two decades. While previous studies have documented socioeconomic disparities in CS use, evidence on how wealth-related inequalities differ between public and private healthcare facilities remains limited. This study assessed the magnitude and drivers of socioeconomic inequality in CS utilization among facility-based births in Bangladesh. Methods We analyzed data from 3,008 facility-based births reported in the 2022 Bangladesh Demographic and Health Survey (BDHS). Survey-weighted multivariable logistic regression was used to identify factors associated with CS utilization. Wealth-related inequality was assessed using concentration curves and the Erreygers-corrected concentration index (ECCI). Regression-based decomposition of the standard concentration index was performed to quantify the contribution of socioeconomic, demographic, and healthcare-related factors to observed inequalities overall and separately for public and private facilities. Results Overall, 71.2% of facility-based births were delivered by CS, with substantially higher prevalence in private facilities (84.2%) than in public facilities (35.9%). Women delivering in private facilities had markedly higher odds of CS than those delivering in public facilities (adjusted odds ratio [AOR]: 9.07; 95% confidence interval [CI]: 7.17-11.47). Significant pro-rich inequality was observed overall (ECCI: 0.154; 95% CI: 0.117-0.191), with inequality substantially greater in public facilities (ECCI: 0.189; 95% CI: 0.114-0.264) than in private facilities (ECCI: 0.049; 95% CI: 0.014-0.084). Decomposition analysis showed that household wealth was the dominant contributor to inequality, particularly the richest wealth quintile, accounting for 81.5% of overall inequality, 63.8% in public facilities, and 109.7% in private facilities. Conclusions Wealth-related inequalities in CS utilization remain substantial in Bangladesh despite widespread use of the procedure. Although pro-rich inequality exists across both sectors, inequality is considerably greater in public facilities and is driven by different mechanisms across facility types. Policies should simultaneously improve equitable access to medically necessary CS and reduce unnecessary procedures, particularly within the private sector.

19.
arXiv (CS.CV) 2026-06-16

A Comprehensive Survey of Medical Image Segmentation: Challenges, Benchmarks, and Beyond

Medical image segmentation plays a critical role in clinical diagnostics, treatment planning, disease monitoring, and neurological disorder identification. This article presents a comprehensive review of its systematic development, covering widely used public datasets, representative methods built on the U-Net, Transformer, and SAM architectures, and key evaluation metrics with their differences, followed by an analysis of major challenges from multiple perspectives. Unlike surveys that focus on a single model family or a specific clinical application, this review organizes U-Net-, Transformer-, and SAM-based methods within a unified analytical framework, with a particular focus on their effectiveness in improving segmentation accuracy and efficiency. This work aims to guide future research and support clinical translation of medical image segmentation, with all related resources publicly available in our GitHub repository: https://github.com/andrew-pengyu/Awsome_MedSeg/tree/main.

20.
arXiv (quant-ph) 2026-06-11

Magneto-Optical Trapping of a Metal Hydride Molecule

arXiv:2512.22350v2 Announce Type: replace-cross Abstract: We demonstrate a three-dimensional magneto-optical trap (MOT) of a metal hydride molecule, CaH. We are able to scatter $\sim$$10^{4}$ photons with vibrational loss covered up to vibrational quantum number $\nu=2$. This allows us to laser slow the molecular beam near zero velocity with a "white-light" technique and subsequently load it into a radio-frequency MOT. The MOT contains $230(40)$ molecules, limited by beam source characteristics and predissociative loss of CaH. The temperature of the MOT is below one millikelvin. The predissociative loss mechanism could, in turn, facilitate controlled dissociation of the molecule, offering a possible route to optical trapping of hydrogen atoms for precision spectroscopy.

21.
arXiv (CS.CV) 2026-06-11

ViT-FREE: Efficient Face Recognition via Early Exiting and Synthetic Adaptation

Vision Transformers (ViTs) have gained significant attention in computer vision and shown strong potential for face recognition (FR). However, their high computational cost makes deployment on resource-constrained devices challenging, motivating the need for methods that balance efficiency and accuracy. In this work, we investigate early exiting in pretrained ViTs as a simple yet effective training-free strategy for efficient FR inference. Leveraging the uniform feature dimensionality across transformer encoder blocks, we introduce ViT-FREE, a multi-exit framework that enables face verification directly from intermediate representations without modifying or retraining the backbone model, and thus, reducing inference cost. Empirically, we show that patch embeddings and attention maps evolve progressively across depth, exhibiting high similarity between consecutive ViT blocks and increasing alignment with the final representation. This indicates gradual feature refinement and attention convergence, suggesting that intermediate layers already provide stable and discriminative representations suitable for early exiting. Through extensive experiments on multiple FR benchmarks, we systematically analyze the accuracy-efficiency trade-off across exit depths. Our results demonstrate that later exits achieve a highly favorable balance, with exiting at layer 10 yielding up to a 20% speedup while incurring only a 1.5 drop in verification performance on benchmarks such as IJB-C. Also, we propose ViT-FREE_FT, a lightweight exit-specific fine-tuning strategy that adapts only the projection layers using a small synthetic dataset while keeping the transformer backbone frozen. This approach improves the performance of shallow exits while preserving the efficiency benefits and leaving deeper exits largely unaffected.

22.
arXiv (quant-ph) 2026-06-16

Neural network inverse design of nanophotonic scintillators

arXiv:2606.16309v1 Announce Type: cross Abstract: Scintillators are materials converting high-energy radiation into optical light, essential in a range of technologies such as medical imaging systems and security scanners. Scintillator development and optimization have remained limited by the complexity of their underlying physics, involving stochastic cascades of electron-electron, electron-phonon, and electron-photon interactions. Such processes are typically modeled by non-differentiable Monte Carlo simulations, limiting the applicability of machine learning for scintillator development. Here we present a physics-informed neural network that learns the scintillation cascade process from the incident high-energy particle to photon emission, substantially accelerating scintillator design and optimization. Combining this neural network with photonic simulations enables end-to-end differentiable optimization of the scintillator geometry. This allows us to optimize for arbitrary figures of merit, such as specific target emission patterns.. We demonstrate the concept and characterize it relative to previous approaches by inverse design of nanophotonic scintillators for X-ray imaging.

23.
arXiv (CS.AI) 2026-06-17

Extracting Semantics: LLM-Guided Automatic Population of Robot Ontology from URDF

arXiv:2606.17073v1 Announce Type: cross Abstract: While commonsense knowledge may suffice for virtual agents, embodied robots interacting with humans require grounded and semantically rich representations of both their environment and their own physical embodiment. In cognitive robotics, ontologies are effective for integrating such heterogeneous knowledge to enable explainable reasoning, even during continuous knowledge updates. Yet, their manual construction remains a bottleneck. We present a preliminary approach for the automatic generation of robot semantic abstractions by transforming Unified Robot Description Format (URDF) models into populated ontologies. Although URDF files provide structural and kinematic descriptions, their identifiers often require commonsense interpretation to recover meaningful semantics, a task at which Large Language Models (LLMs) excel. Our pipeline leverages LLMs to infer semantic relationships by prompting them with concepts from an existing ontology, ensuring the final classification remains aligned with the formal model. To improve reliability, the pipeline combines majority voting across multiple LLM queries along with syntactic and schema-level validation to ensure that generated outputs conform to the expected representation format and ontology constraints. We evaluate the approach on multiple robot descriptions and discuss the generated abstractions. Initial results indicate that the proposed method can effectively bridge the gap between low-level robot descriptions and the structured, grounded knowledge representations required for human-robot interaction.

24.
arXiv (math.PR) 2026-06-18

Denoising Distances in Metric Measure Spaces

arXiv:2606.18301v1 Announce Type: cross Abstract: Recent work studied the problem of finding clusters and denoising pairwise distances from noisy distances of points sampled on a manifold. We study the same problems in more general metric measure spaces under \lowerphiregularity{}. We give an algorithm that extracts large localized clusters around every sampled point and uses them to denoise distances to any fixed accuracy, with near-linear running time in the dense fixed-accuracy regime. We also show how to achieve much higher accuracy with a non-efficient algorithm. This suggests that unlike the Riemannian case, denoising to higher accuracy in more general metric spaces has a statistical-computational gap.

25.
arXiv (CS.CV) 2026-06-16

K-Prism: A Knowledge-Guided and Prompt Integrated Universal Medical Image Segmentation Model

Medical image segmentation is fundamental to clinical decision-making, yet existing models remain fragmented. They are usually trained on single knowledge sources and specific to individual tasks, modalities, or organs. This fragmentation contrasts sharply with clinical practice, where experts seamlessly integrate diverse knowledge: anatomical priors from training, exemplar-based reasoning from reference cases, and iterative refinement through real-time interaction. We present $K-Prism$, a unified segmentation framework that mirrors this clinical flexibility by systematically integrating three knowledge paradigms: (i) $semantic priors$ learned from annotated datasets, (ii) $in-context knowledge$ from few-shot reference examples, and (iii) $interactive feedback$ from user inputs like clicks or scribbles. Our key insight is that these heterogeneous knowledge sources can be encoded into a dual-prompt representation: 1-D sparse prompts defining $what$ to segment and 2-D dense prompts indicating $where$ to attend, which are then dynamically routed through a Mixture-of-Experts (MoE) decoder. This design enables flexible switching between paradigms and joint training across diverse tasks without architectural modifications. Comprehensive experiments on 18 public datasets spanning diverse modalities (CT, MRI, X-ray, pathology, ultrasound, etc.) demonstrate that K-Prism achieves state-of-the-art performance across semantic, in-context, and interactive segmentation settings.